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All 18 FDA-approved contraceptives are available in all 50 U.S. states. Federal funding for public distribution of birth control varies by state: 26 states have enacted supplemental mandates and policies for increasing the availability of FDA-approved contraception. Title X funding involves allocations on the federal, state, and local levels for family planning services.

Despite widespread availability of both prescription and implantable contraceptive devices, there are still contraceptive deserts in many states. According to PowertoDecide.org, contraceptive deserts occur when there is less than one clinic available providing full access to all methods of birth control per 1,000 women in need of publicly funded birth control options. An overview of contraceptive availability by state is provided in this brief. Also included are rankings in terms of teen pregnancy and birth rates, public funding mandates, and supplemental policies regarding increasing availability and prescription supplies for each of the 50 states in the country.

Pharmacists Prescribing Self-Administered Contraception

Since 2016, 10 states (California, Colorado, Hawaii, Maryland, New Hampshire, New Mexico, Oregon, Tennessee, Utah, and Washington D.C.) have enacted legislation or regulations that allows pharmacists to prescribe and dispense self-administered hormonal contraceptives.

More than 1-3 packs of birth control at a time

To increase timely access to contraception and reduce gaps in contraceptive use, since 2016, 19 states (including Washington, D.C.) have enacted legislation requiring insurers to increase the number of months for which they cover prescription contraceptives at one time. 7 Most of these require 12 months of coverage for prescription contraceptives at one time versus usual the 30- to 90-day supplies that insurance plans traditionally cover.

Alabama

There are no contraceptive deserts for prescription contraceptives in Alabama. However, there are deficient areas for implantable devices.

The state ranks the 9th highest for teen birth rate and the 11th highest in the nation for teen pregnancies.

Alabama provides an extension of Medicaid family planning services under Title X of the Federal Public Health Service Act. The Alabama extension program is known as the Alabama Medicaid Plan First Program and is available to all women between the ages of 19 and 55, which are ineligible for family planning programs through Medicaid. Women meeting the income eligibility of 141% of the Federal Poverty Level or less, who are Alabama citizens or meet alienage requirements, and are 60 days or more postpartum, qualify for family planning benefits through this program.

Covered services include: birth control methods like pills, injections, patches, vaginal rings, diaphragms, and intrauterine devices. Tubal ligations, embedded devices, and vasectomies for males are approved for certain settings under documented conditions. The Plan First program covers both initial and annual visits as well as periodic re-visits as indicated. In addition, STD and pre and post HIV test counseling services are also covered.

Alaska

Alaska ranks the 12th highest for teen birth rate and 36th for teen pregnancy rates in the nation.

In 2010, 48% of all pregnancies in Alaska were unintended.

By averting unintended pregnancies and other negative reproductive health outcomes, publicly funded family planning services provided by safety-net health centers in Alaska helped save the federal and state governments $65.4 million in 2010.

Cool law on the horizon: On April 9th, 2018, House Bill 25 passed, which mandates health insurance companies and Medicaid in Alaska to cover prescription birth control and medical services to obtain any woman’s preferred method of choice. This includes traditional prescriptions, implantable devices, and long acting reversible contraceptives. In addition, insurance companies are required to cover a full year’s supply. The bill will now be sent to the Alaska State Senate for ratification. As of August 1, 2018, it was still stuck in the Senate. Ask your State Senator to VOTE yes.

Arizona

According to Power to Decide’s Access to Contraception map. There are no significant contraceptive deserts in the state of Arizona. Arizona health clinics offer family planning services with a full range of contraceptive options under the eligibility requirements of Title X. In the state, 28 clinics receive support from Title X. They include local health department clinics (13), federally qualified health centers (10), and Planned Parenthood clinics (5).

A bill was introduced into the Arizona legislature such that employers may opt out of insurance mandates for contraceptives. As of January 2018, the bill is still held in committee discussions.

The state of Arizona is ranked the 19th highest in teen birth rate and 15th highest for teen pregnancies.

Arkansas

Although Arkansas ranks #1, having the highest teen birth rate in the U.S. and 2nd highest for teen pregnancy (powertodecide.org), there are no significant contraceptive deserts.

The state has expanded its Medicaid program to childless individuals. However, now there are no further increases in birth control prescription requirements in addition to its federal Title X funding programs. As of 2016, 94 clinics in Arkansas receive Title X funding and all are operated by the state’s health department.

California

Overall, no significant contraceptive deserts were noted in California. However, approximately a dozen counties are deserts for embedded devices, such as implants and IUDs.

In addition, California implemented measures extending their Medicaid program to childless eligible recipients, and a reimbursement program for eligible postpartum recipient for long acting reversible contraceptives. California has its Family PACT program which covers people up to 200% of the Federal Poverty Level for the diagnosis and prevention of pregnancy and diagnosis, prevention, and treatment of sexually transmitted disease, though it does not cover the HPV vaccine.

In addition, California’s Contraceptive Coverage Equity Act of 2014 mandates that all private insurance plans must cover a minimum of one contraceptive option in each of the 18 distinct FDA approved prescription categories for women without cost sharing.

Colorado

There are no significant contraceptive deserts noted, although 4 counties do have fewer clinics available to meet current population needs and ~ 10 counties are deserts for implantable devices.

Pharmacists Prescribing Self-Administered Contraception: Yes

As of 2014, 73 clinics received federal Title X funding for family planning services. Of the 73 clinics, 39 are local health departments, 27 are federally qualified health centers, and 4 are hospitals. The remaining three are comprised of family planning clinics and other sites. Federal funding reductions between 2010 and 2016 caused a decrease in 28% of patients served under Title X. Despite funding reductions, The Colorado Family Planning Initiative has created such positive impacts that an additional $2.5 million was allocated to the family planning program, throughout FY 2016 and 2017, to sustain the effects. In Colorado, the Medicaid program was expanded to childless eligible recipients and measures to increase access to and lengthen prescription supplies for contraceptives were also added.

Connecticut

There are no significant contraceptive deserts noted in the state of Connecticut for both prescription contraceptives and implanted devices.

The state has expanded its Medicaid program to include eligible recipients without children and funds postpartum reimbursements for long acting contraceptives. However, there are no state induced mandates for increasing access to prescription contraceptives or increasing prescription lengths. 26 clinics in Connecticut receive federal Title X funding for contraceptives, of which 12 are Planned Parenthood clinics, 12 are school-based clinics, and 2 are federally qualified medical centers. Connecticut also saw a reduction in Title X funding resulting in an 11% reduction of patients served. Connecticut had the 3rd lowest teen birth rate in 2016.

Delaware

There are no significant contraceptive deserts in the state of Delaware for both prescription and implanted device options. Delaware has expanded its Medicaid program to include eligible recipients without children. In addition, Delaware also provides Medicaid reimbursement for long acting contraceptives. Although the state does not have mandates for increased access to contraception and longer prescription lengths, the state launched an initiative in 2016, known as the Delaware Contraceptive Now or CAN initiative. This partnership between both public and private entities has received over $10 million in private funding and $1.75 million in funding from the Delaware Department of Public Health towards increasing prescription contraception access and pregnancy prevention education. As of 2014, 45 clinics in Delaware received Title X funding. School-based health centers account for 21 clinics, 7 clinics fall under the auspices of state health and social services centers, 5 are locally operated health departments, 3 are Planned Parenthood clinics, 1 is a university health center, and 3 are classified as other sites.

Florida

Florida has not expanded its Medicaid program to include eligible childless participants, however it does offer Medicaid reimbursement for postpartum recipients for long acting contraception. In addition, the state has not issued mandates for increasing access to contraceptives, nor has it issued legislation for increased prescription supply lengths. As of 2014, 157 clinics received funding from Title X,of which 138 are health departments, 13 are federally qualified health care centers, 3 are planned parenthood clinics, 2 are university health centers, and 1 other site. Funding cuts between 2010 and 2016 decreased availability of contraceptive services for close to half of its qualified residents, or 47%. Florida is ranked 24th in terms of teen birth rates and 31st for teen pregnancy.

Georgia

There are no significant contraceptive deserts noted in the state of Georgia for prescription birth control: however, 8 counties are deficient for implantable devices surrounding the central region. The state of Georgia has not expanded its Medicaid program to include participants without children although reimbursement is provided for postpartum patients for long acting contraception. As of 2014 there were also no state issued mandates increasing access to contraceptives nor increased prescription length. As of 2016, Georgia ranked 32nd in terms of teen birth rates and 36th for teen pregnancy rates. In Georgia, 135 clinics are federally funded by Title X, of which 124 are federally qualified health centers, 6 are Planned Parenthood clinics, 3 are covered under Family Health Centers of Georgia, 1 is a hospital, and 1 is covered under other services.

Hawaii

The islands of Hawaii boast no significant contraceptive deserts and only 1 county is noted deficient in implantable devices.

Pharmacists Prescribing Self-Administered Contraception

Hawaii ranks 23rd in terms of teen birth rate and 30th in teen pregnancy rate. The state has expanded its Medicaid program to include eligible recipients without children and provides reimbursement for long acting contraceptives for postpartum patients. Hawaii has state laws and policies in place to increase access to prescription contraceptives as well as policies to increase prescription lengths. 37 clinics receive federal Title X funding and consist of 25 federally qualified health centers, 5 hospitals, 4 university health centers, 2 Planned Parenthood clinics, and 1 other service site.

Idaho

The state of Idaho has no significant contraceptive deserts with the exception of Boise County for prescription birth control. Significant deserts do exist in the northeastern most and southeastern most areas of the state in terms of implantable devices. Idaho ranks 26th in terms of teen birth rate and 14th for teen pregnancies. Medicaid programs have not been expanded to include recipients without children; however, the state mandates reimbursements for long acting contraceptives for postpartum recipients. The state of Idaho has 48 clinics receiving Title X funding, of which 45 are health departments, 2 are Planned Parenthood clinics, and 1 other service site.

Illinois

About a dozen counties in Illinois are significant prescription birth control deserts, and scattered counties throughout the state are deficient in publicly funded sites for implantable devices. Illinois ranks 21st in the country. Illinois ranks 21st in teen birth rates and 28th in teen pregnancies. The state has expanded its Medicaid program to accommodate eligible recipients without children and mandates postpartum reimbursements for long acting contraceptives. Its contraceptive equity law has also been updated to include insurance plan coverage for all FDA contraceptives, including OTC contraceptives, except male condoms, at no out-of-pocket expense (powertodecide.org). As of 2014, Illinois contains 94 Title X funded clinics. Federally qualified health centers account for 30, 25 are run by local health departments, 16 are Planned Parenthood clinics, and 10 are Aunt Martha’s Health Centers. There are also 6 school-based clinics, 3 hospital-based clinics, 2 family planning health centers, and 2 classified as other sites.

Indiana

Prescription contraceptive deserts are found in over 20 counties in Indiana, and more counties are deficient in publicly funded implantable devices. Despite these high numbers, teen pregnancy rates have dropped 19% since 2010. Indiana ranks 32nd for teen birth rates and 26th in teen pregnancies. The state of Indiana has expanded its Medicaid program to include eligible recipients without children and reimbursements are also extended to postpartum patients for long acting contraceptives. There are no mandates or policies in place increasing access to birth control and lengthening prescription supply. As of 2014, 36 clinics receive Title X funding, of which 14 are federally qualified health centers, 13 are family planning centers, 6 are Planned Parenthood clinics, 1 is a health department, 1 is a university-based clinic, and 1 is a school-based health center.

Iowa

Iowa has very few significant birth control deserts, however there are widespread areas of low access to publicly funded clinics. According to Power to Decide, there are widespread deficiencies in access to implantable devices. Despite this fact, Iowa is ranked 18th in the country for teen birth rates and 9th for teen pregnancies. In addition, Iowa’s teen birth rate has declined by 24% since 2010. The state of Iowa contains a fully funded state program, which provides family planning services to qualified recipients with incomes as high as 3 times the federal poverty level. Iowa has expanded their Medicaid program to include recipients without children and Medicaid reimbursements are provided for postpartum patients desiring long acting contraception. Iowa maintains 40 clinics funded by Title X, of which 12 are health departments, 9 are federally qualified health centers, 6 are planned parenthood clinics, 5 are hospitals, 2 are family planning health centers, 1 is a student health center, and 5 are classified as other sites. Federal funding cuts did not significantly affect the state of Iowa between 2010 and 2016 due to its fully state funded family planning program.

Kansas

3 counties in the state of Kansas are significant prescription contraceptive deserts. In addition, there are approximately 8 to 10 counties that are deficient in access. The majority of the state is significantly deficient with regards to publicly funded clinics offering implantable devices. Kansas is ranked 30th in terms of teen birth rate and 22nd for teen pregnancies. Kansas has not expanded its Medicaid program to eligible recipients without children and it does not offer reimbursement for long acting contraceptives to postpartum recipients. The state does however have close to $2.5 million allocated for its 65 Title X clinics. These clinics are almost exclusively run by health departments with only 1 operating as a federally qualified health center.

Kentucky

There are no significant birth control deserts in the state of Kentucky with the exception of implantable devices. Kentucky ranks 46th in terms of teen birth rates and 43rd in teen pregnancies. The state has expanded its Medicaid program to include eligible recipients without children and mandates Medicaid reimbursement to eligible postpartum patients for long acting contraceptives. Kentucky has no mandates of policies for increased access to contraception and lengthening prescription supply. The state houses 125 Title X funded clinics, of which 122 are operated by local health departments, 2 are federally qualified health centers and 1 is a university health center.

Louisiana

There are no significant contraceptive deserts in the state of Louisiana with the exception of 2 parishes near New Orleans. Implantable devices are also readily available via public funding throughout the state. Despite availability, Louisiana ranks 45th in the country with respect to teen birth rates and 44th in teen pregnancies. The state has expanded its Medicaid program to eligible participants without children and also offers Medicaid reimbursements to postpartum patients for long acting contraception. 65 clinics in Louisiana are federally funded by Title X, of which 63 pertain to the Louisiana Department of Public Health, 1 is operated by a local health department and 1 is a university health center. The state of Louisiana’s Take Charge Program is available to all women of childbearing age with an income less than or equal to 138% of the federal poverty level.

Maine

There are no significant contraceptive deserts with regards to both prescription methods and implantable devices.Maine ranks 9th in the country in terms of lowest teen birth rates and 7th in teen pregnancies. This is attributable to state legislation permitting the distribution of birth control pills to middle and high school students as well as a state law requiring insurance plans to approve 1 year supplies of prescription birth control. 42 clinics in Maine are funded by Title X, with 18 operated by the Family Planning Association of Maine. The remaining 24 consist of 15 federally qualified health centers, 5 school-based health centers, and 4 Planned Parenthood clinics.

Maryland

Birth control is readily available in Maryland with no contraceptive deserts noted for neither prescription methods nor implantable devices.

Pharmacists Prescribing Self-Administered Contraception

The state ranks the 14th lowest in terms of teen birth rates and 26th in teen pregnancies. Maryland has expanded its Medicaid program to accommodate recipients without children and mandates reimbursements to postpartum patients for long acting contraceptives. Maryland has state legislation in effect to increase access to birth control and mandates longer prescription supplies. Its Contraceptive Equity Act went in effect in January 2018 and mandates insurance coverage for all birth control methods with no out of pocket expenses. The law also eliminates copays for emergency contraception and long acting contraceptives. Maryland has 75 clinics receiving Title X funding, of which 34 are health departments, 16 are federally qualified health centers, 14 are school-based health centers, 9 are Planned Parenthood clinics, and 4 are university health centers.

Massachusetts

There are no significant contraceptive deserts for neither prescription birth control nor implantable devices.

Massachusetts had the lowest teen birth rate in the entire U.S in 2016.

Massachusetts has expanded their Medicaid program to include eligible recipients without children. In addition, the state passed a law in 2017 mandating insurance plans to cover at least one birth control method in each of the 18 FDA-approved categories with the exception of condoms. Medicaid reimbursements are also available to postpartum patients for long acting contraception. The state ranks the lowest in the nation for teen birth rates and 2nd lowest for teen pregnancies. Massachusetts has 93 Title X funded clinics, of which 36 are federally qualified health centers, 15 are hospital-based, 12 are school health centers, 12 are operated by Health Imperative, Inc., 8 are family planning health centers, 5 are Planned Parenthood clinics, 3 are operated by Health Quarters, Inc., 1 university health center, and 1 health department.

Michigan

Only one county in the state of Michigan qualifies as a prescription contraceptive desert, however, scattered deserts are noted for implantable devices.

Michigan ranks 19th in terms of teen birth rate and 21st in the nation for teen pregnancies.

The state has expanded its Medicaid program to include eligible recipients without children, but it does not mandate reimbursements to postpartum patients for long acting contraceptives. The state does not have supplemental laws of policies increasing access and prescription lengths for birth control. Michigan contains 90 clinics receiving Title X funding, of which 71 are health departments and 19 are Planned Parenthood clinics.

Minnesota

Minnesota contains approximately six counties meeting the qualification for prescription contraceptive deserts. In addition, there are widespread areas throughout the state deficient in public resources for implantable devices.

The state is ranked the 6th lowest state in the nation regarding teen birth rates and the 3rd lowest for teen pregnancies.

Minnesota has expanded its Medicaid program to accommodate eligible recipients with no children; however, reimbursements are not provided to postpartum patients for long acting contraceptives. In March 2018, Minnesota legislators introduced a bill, which when enacted, will mandate insurance coverage for all FDA-approved birth control methods with no copays. The bill is known as the Protect Access to Contraception Act. Presently, 38 clinics in Minnesota receive Title X funding, of which 17 are Planned Parenthood clinics, 7 are operated by the St. Paul-Ramsey County Department of Health, and 14 are categorized as other service sites.

Mississippi

Mississippi has no significant contraceptive deserts for both prescription birth control and implantable devices.

Mississippi has not expanded its Medicaid program to include eligible recipients without children. The state does offer Medicaid reimbursements to postpartum patients for long acting contraceptives. There are also no supplemental policies or mandates to extend prescriptions or increase access to birth control. 125 clinics receive Title X funding in the state, of which 97 are operated by health departments, 26 are federally qualified health centers, 1 clinic is university-based and 1 is classified as other service site.

Missouri

The state of Missouri contains over two dozen counties that are considered contraceptive deserts for prescription birth control. There are also widespread deserts for implantable devices.

Missouri is ranked 31 in terms of teen birth rate and 28th in the nation for teen pregnancy. (The higher the ranking the higher the rate.) The state has not expanded its Medicaid program to accommodate eligible recipients without children, although Missouri does operate on a purely state-funded program, providing family planning service to women over the age of 18 with incomes up to 185% of the federal poverty level. Missouri has 64 clinics receiving Title X funding, including 37 health departments, 12 family planning health centers, 6 federally qualified health centers, 5 Planned Parenthood clinics, 3 hospitals, and 1 other service site.

Montana

Montana has about a dozen counties meeting the criteria for contraceptive deserts. Most of Montana is also a contraceptive desert for implantable contraceptive devices. Ironically, areas deficient in prescription methods are not deficient in implantable devices and vice-versa.

Montana ranks 35th in the country in terms of lowest birth rates among teens, and 23rd for lowest teen pregnancy rates.

The state has expanded its Medicaid program to include eligible recipients without children and provides reimbursements for postpartum long acting contraceptives for postpartum patients. Montana does not have supplemental legislation or policies increasing access to contraceptives or lengthening prescription supplies. 29 clinics in Montana receive Title X funding, including 18 health departments, 5 Planned Parenthood clinics, 5 federally qualified health centers, and 1 family planning health center.

Nebraska

Nebraska ranks 22nd in terms of lowest teen birth rates in the country and 12th for lowest teen pregnancy rates.

According to Live Well Nebraska, most employers in the state offer covered birth control services at no cost to their employees. However, Trump rulings have allowed employers to opt out of birth control mandates imposed by ACA. It is unclear how these changes are going to affect the state of Nebraska. 24 Nebraska clinics receive Title X funding, including 23 federally qualified health care centers, 9 other service sites, 4 hospitals, 2 Planned Parenthood clinics, 1 tribal health center, and 1 local health department clinic.

Nevada

Only one county in Nevada is considered a contraceptive desert in terms of prescription birth control. Approximately half a dozen counties in Nevada, however, qualify as contraceptive desert in terms of publicly funded sites for implantable devices.

Nevada is ranked 37th in the country in terms of lowest teen birth rate and 41st for lowest teen pregnancy rate.

Nevada enacted two laws effective in January 2018 mandating all public and privately funded health plans to provide coverage for all FDA-approved contraceptives for women with no copays or out-of-pocket costs. A second law establishes a state program issuing grants for family planning services. Nevada has expanded its Medicaid program to include eligible recipients without children and has enacted mandates extending supplies for prescription contraceptives. 22 state and local health departments receive Title X funding in the state of Nevada.

New Hampshire

Both prescription and implantable birth control options are readily available in the state of New Hampshire.

Pharmacists Prescribing Self-Administered Contraception: Yes

12 month supply of birth control: Yes

The state boasts the second lowest teen birth rate in the country and the lowest teen pregnancy rate.

New Hampshire laws mandate that insurers cover birth control in the same fashion as other prescription medications. The state also rejected the measure to allow employers to opt out of birth control offerings for their employees. The state has also expanded its Medicaid program to include eligible recipients without children but does not provide reimbursement for long acting reversible contraceptives postpartum. The state has 15 clinics receiving Title X funding, including 8 federally qualified health centers, 5 Planned Parenthood clinics, and 2 family planning health centers.

New Jersey

Birth control is readily available in New Jersey. There are no notable contraceptive deserts in the state for prescription and implantable options.

New Jersey holds the 5th lowest teen birth rate in the country and 14th lowest for teen pregnancies.

The state has expanded its Medicaid program to include eligible recipients without children and has secured the possibility of State Plan Amendment to offer family planning services for women with incomes up to 200% of the federal poverty level. There are also state mandates and policies in effect lengthening prescription supplies for contraceptives. 45 clinics in New Jersey are supported by Title X funding including 24 Planned Parenthood clinics, 10 federally qualified health centers, 10 family planning health centers, and 1 local health department clinic.

New Mexico

There are no contraceptive deserts in New Mexico and only about 5 counties have deficiencies in publicly funded sites for implantable devices.

Pharmacists Prescribing Self-Administered Contraception: Yes.

The state ranks 44th in terms of lowest teen birth rates and ranks last in the country for teen pregnancies. New Mexico has extended their Medicaid program to include eligible recipients without children. The state also issues Medicaid reimbursements for postpartum long-acting contraceptives. In addition, New Mexico has implemented efforts to improve digital communications for consumers and providers as well as training for rural area clinics. The state plans on piloting long acting reversible contraceptives in 2 of its deficient counties. New Mexico has 67 clinics, of which 43 are operated by health departments, 10 are federally qualified health centers, 12 are school-based clinics, 1 is a university-based health center, and 1 other service site.

New York

The state of New York has no prescription contraceptive deserts and only a handful of deficient counties for implantable devices.

New York has the 8th lowest teen birth rate in the nation and ranks 33rd in the country for teen pregnancy. New York has expanded its Medicaid program to include eligible recipients with no children. Medicaid reimbursements are also provided for postpartum long acting contraceptives. The state has also implemented regulations mandating health insurance plans to cover a minimum of 1 method in each of the 18 FDA-approved categories for contraception. New York has 187 clinics supported by Title X funding, including 64 Planned Parenthood clinics, 50 federally qualified health centers, 32 hospitals, 19 health department clinics, 18 family planning centers, 2 Public Health Solutions clinics, and 2 other service sites.

North Carolina

There are no prescription contraceptive deserts in the state of North Carolina. However, ~ 10 counties are deficient in implantable devices.

North Carolina ranks 28th in the country for teen birth rates and 30th in teen pregnancies.

North Carolina has not expanded their Medicaid program to include eligible recipients without children. Medicaid reimbursement is provided for postpartum long acting contraceptives. North Carolina does not have supplemental mandates increasing pharmaceutical access to contraception or extending prescription supplies. There are 117 clinics in North Carolina receiving Title X funding, of which 112 are operated by Health Departments, and 5 are Planned Parenthood clinics.

North Dakota

North Dakota has pockets of areas deficient in publicly funded clinics offering prescription contraception. There is only 1 significant contraceptive desert. With regards to implantable devices, there are only about a dozen counties with publicly funded approved sites.

North Dakota is ranked 38th in the country for teen birth rates and 20th for teen pregnancies.

The state has expanded its Medicaid program to include eligible recipients without children however there are no reimbursements for postpartum long acting contraceptives. In addition, North Dakota laws do not mandate sex education. The decision to provide sexual education is left up to local schools. There are 18 clinics in North Dakota receiving Title X funding, of which 14 are health departments, 2 are university health centers, and 1 other service site.

Ohio

The state of Ohio has approximately 10 counties classified as contraceptive deserts for prescription birth control. Widespread areas are also noted to be deficient in publicly funded sites offering implantable devices.

The state has expanded its Medicaid program to include eligible recipients without children and provides reimbursement for postpartum long acting contraceptives. Ohio has also passed a law implementing recommendations for Infant Mortality Prevention. The measure promotes technical assistance to Title X health centers interested in increasing the awareness and use of long acting contraceptives. 87 clinics in Ohio are funded by Title X, including 49 health departments, 18 Planned Parenthood clinics, 8 other sites, 7 family planning centers, and 5 federally qualified health centers.

Oklahoma

Prescription birth control is readily available in Oklahoma. However there are a few counties on the western side with limited access to publicly funded sites offering implantable devices.

Oklahoma holds the second highest teen birth rate in the nation and the 5th highest teen pregnancy rate. The Medicaid program has not been expanded in Oklahoma to include eligible recipients without children, although the state does offer Medicaid reimbursement for long acting contraception. There are no supplemental laws or policies increasing pharmaceutical access to contraception or supply lengths. Oklahoma also has laws requiring parental consent for teens desiring prescription birth control. 99 clinics in Oklahoma receive funding from Title X including 97 Oklahoma State Department of Health centers and 2 Community Health.

Oregon

Oregon has no significant contraceptive deserts for both prescription birth control methods and implantable devices.

In 2016, House Bill 3343 went into effect, making Oregon the first state in the nation to require health insurers to give a year’s supply of the pill, the patch or the ring at the same time! Dispensing a one-year supply of birth control is associated with a 30 percent reduction in the odds unplanned pregnancy compared with dispensing 30 or 90 days. If it’s a new prescription — meaning you have never tried this birth control brand at any point in the past — you will first receive a 90-day supply. All subsequent refills will be for a full year.

Oregon passed a law in 2017 requiring private insurers to cover all services listed under the Federal Women’s Preventive Services Guidelines. These guidelines include coverage for all contraceptive methods including over-the-counter methods. Oregon also utilizes state funds to provide coverage for women of childbearing age but not eligible for Medicaid under immigration laws. Oregon has expanded its Medicaid program to include eligible recipients without children and reimbursements are available for postpartum access to long acting contraception. 97 clinics in the state of Oregon receive Title X funding, of which 63 are operated by health departments, 24 are school-based health centers, 6 are federally qualified health centers, and 4 are Planned Parenthood clinics. Oregon holds the 15th lowest teen birth rate in the country and 14th lowest teen pregnancy rate.

Pensylvania

The state of Pennsylvania has no significant prescription birth control deserts. There are, however, about a dozen county with limited access to publicly funded clinics offering implantable devices. Pennsylvania holds the 13th lowest teen birth rate in the country and the 12th lowest teen pregnancy rate. Pennsylvania has expanded its Medicaid program to include eligible recipients without children and offers reimbursement for postpartum long acting contraceptives. Pennsylvania has no supplemental mandates or policies increasing pharmaceutical access to birth control or lengthening prescription supplies. There are 191 clinics supported by Title X in Pennsylvania, of which 59 are federally qualified health centers, 36 are hospitals, 28 are Planned Parenthood clinics, 13 are school-based health centers, 11 are operated by Adagio Health clinics, 10 are operated by health departments, 9 are classified as other sites, 4 are operated by Maternal and Family Health Services, and 2 are Access Matters clinics.

Rhode Island

There are no contraceptive deserts for both prescription contraceptives and implantable devices in Rhode Island. The state has the 7th lowest teen birth rate in the country and the 9th lowest rate of teen pregnancies. Rhode Island has expanded its Medicaid program to include eligible recipients without children, however the state does not offer reimbursement for long acting contraception for postpartum patients. Rhode Island is in the process of passing laws similar to Massachusetts, in which insurance companies would be required to cover 12 month supplies of birth control for plan participants. As of the present there are no supplemental policies or regulations increasing access to birth control or lengthening prescription supplies. 23 clinics in Rhode Island receive Title X funding, of which 19 are school-based health centers, 2 are Planned Parenthood clinics, and 1 other service site.

South Carolina

There are no significant contraceptive deserts in the state of South Carolina for both prescription and implantable devices. South Carolina ranks 35th in the nation in terms of teen birth rates and 39th for teen pregnancies. The state has not expanded its Medicaid program to include eligible recipients without children. South Carolina does offer Medicaid reimbursements for postpartum long acting contraceptives. There are no supplemental mandates increasing access to prescription birth control nor lengthening prescription supplies. South Carolina has 55 clinics receiving Title X funding and all of them are operated by the South Carolina Department of Health and Environmental Control.

South Dakota

There are no significant prescription contraceptive deserts in the state of South Dakota; however, the state is widely deficient in publicly funded sites offering implantable devices. South Dakota is the 35th lowest in terms of teen birth rate and ranked 39th for teen pregnancies in the nation. South Dakota has not expanded its Medicaid program to include eligible recipients without children. Reimbursements are also not provided for postpartum long acting contraceptives. In addition, there are no supplemental regulations or policies increasing access to prescription birth control or lengthening prescription supplies. 49 clinics receive Title X funding, of which 32 are health departments, 8 are operated by the South Dakota Department of Health, 8 are classified as other service sites, 3 are federally qualified health center, 2 are tribal health centers, 1 is a family planning health center, and 1 is university-based.

Tenenssee

The state of Tennessee has no significant birth control deserts for prescription contraceptives. There are only a handful of counties deficient of publicly funded clinics offering implantable devices.

Pharmacists Prescribing Self-Administered Contraception

Tennessee is ranked 41st in the country for teen birth rates and 41st in terms of teen pregnancies. The state has not expanded its Medicaid program to include eligible recipients without children but does offer Medicaid reimbursement for postpartum long acting contraceptives. There are no active supplemental policies increasing access to contraceptives and lengthening prescription supplies. Tennessee has 119 clinics receiving Title X funding and all of them are operated by the local health department.

Texas

Widespread deficiencies are noted for publicly funded clinics offering prescription birth control. Three counties in Texas are also considered significant contraceptive deserts. There are also approximately 2 dozen counties in the state that are deficient in access to publicly funded implantable devices.Texas has the 4th highest teen birth rate in the nation and the 5th highest teen pregnancy rate. Texas has not expanded its Medicaid program to include recipients without children nor does it offer reimbursement for postpartum long acting contraceptives. There are no supplemental mandates or regulations increasing pharmaceutical access to birth control or lengthening prescription supplies. The state budget for 2016-2017 mandated that the Health and Human Services Commission and Department of State Health Services implement initiatives to increase awareness and use of long acting removable contraceptives and the state now operates on a fully funded program providing family planning services to women 18 years and older with incomes up to 185% of the federal poverty level. The state of Texas has 94 clinics receiving Title X funding, including 25 health departments, 21 family planning centers, 20 federally qualified health centers, 14 hospitals, 11 Planned Parenthood clinics, 2 other service sites, and 1 university health center.

Utah holds the 12th lowest teen birth rate and the 4th lowest teen pregnancy rate. The state has not expanded its Medicaid program to include eligible recipients without children but does offer reimbursement for long acting contraceptives. There are also no state supplemental mandates increasing pharmaceutical access to birth control or lengthening prescription supplies. 19 clinics in Utah receive Title X funding, including 8 Planned Parenthood clinics, 7 family planning health centers, and 4 federally qualified health centers. Utah passed a birth control law in March 2018 allowing women to access birth control directly from their pharmacist. The law applies to women 18 and older desiring pills, patches, and other devices.

Vermont

Both pharmaceutical and implantable devices are readily available in the state of Vermont. The state ranks the 4th lowest in terms of teen birth rates and teen pregnancy rates. Vermont contains its own state funded family planning initiative, allowing anyone with incomes up to 200% of the federal poverty rate access to contraception. Vermont also enacted regulations mandating all publicly and privately funded health insurance plans to cover all FDA-approved categories of contraception without out-of-pocket expenses. State regulations also apply to male vasectomies. In addition, the Department of Health is mandated to uphold sliding scale payments for the insertion and removal of long acting contraceptives. The state has expanded its Medicaid program to include eligible recipients without children and provides reimbursement for postpartum long acting contraceptives. There are also regulations lengthening prescription supplies. Planned Parenthood operates all 10 clinics receiving Title X funding in the state of Vermont.

Washington

Both prescription contraceptives and implantable devices are readily available in the state of Washington.

The state is ranked 15th lowest in the nation for teen birth rates and 18th for teen pregnancy.

Washington has expanded its Medicaid program to include recipients without children and offers reimbursement for postpartum long acting reversible contraceptives. The state also has supplemental mandates increasing pharmaceutical access to birth control and lengthening prescription supplies. 72 clinics in Washington receive Title X funding, including 33 Planned Parenthood clinics, 21 federally qualified health centers, 8 health department clinics, 7 school-based health centers, and 3 family planning centers.

West Virginia

The state of West Virginia contains no pharmaceutical contraceptive deserts and only 3 counties are significantly devoid of publicly funded clinics offering implantable devices.

West Virginia holds the 7th highest amount of both teen birth rates and teen pregnancies. The state has not expanded its Medicaid program to include recipients without children but does provide reimbursement for postpartum long acting contraceptives. There are no supplemental mandates increasing access to pharmaceutical contraceptives or lengthening covered prescription supplies. 165 clinics in West Virginia receive Title X funding, including 87 federally qualified health centers, 42 health departments, 23 school clinics, 9 university health centers, 3 hospitals, and 1 Planned Parenthood clinic.

Wisconsin

Pharmaceutical contraceptives are readily available in Wisconsin; however, there are widespread deficiencies in publicly funded clinics offering implantable devices.

Wisconsin holds the 10th lowest teen birth rate and 4th lowest teen pregnancy rate in the nation. The state has not expanded its Medicaid program to include recipients without children and does offer reimbursement for postpartum long acting contraceptives. There are no supplemental mandates increasing access to prescription birth control or lengthening prescription supply lengths. Wisconsin does mandate insurance coverage for contraception for its employees for all 18 FDA-Approved birth control categories. 18 clinics receive Title X funding, including 9 Planned Parenthood clinics, 8 family planning centers, and 1 tribal health center.

Wyoming

Prescription birth control is readily available in the state of Wyoming. However, there are pockets of deficiencies in publicly funded clinics offering implantable devices.

Wyoming holds the 10th highest teen birth rate and ranks 23rd in terms of teen pregnancy. The state has not expanded its Medicaid program to include eligible recipients without children and it does not offer reimbursement for postpartum long acting contraceptives. 19 clinics in Wyoming receive Title X funding, including 11 family planning clinics, 7 health departments, and 1 university health center.